Is it bad to replace one breast due to a capsule contracture? My other breast is fine

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

From a technical standpoint it is better to replace both implants so the surgeon can control the cosmetic appearance.

Thanks for your question.  I think that you have a few options. Yes, you can just have the side with CC addressed. The potential issue with this is that the newly operated breast may heal a bit differently that the non operated breast. When correcting CC, I discuss with my patients the option of exchanging both implants, as sometimes that will allow me the option to create the best symmetry possible.  As far as the use of textured implants, some studies have shown that the use of textured implant may decrease the risk of CC. I am assuming that you have smooth implants now.  Obviously, your left breast has healed without issue, so the smooth implant itself has not "caused" the CC.  Usually, CC is a result of some degree of bacterial contamination, usually from the breast tissue itself, or implant rupture.  I would discuss the pros and cons of one side vs both sides and textured vs smooth with your PS. If your implants have been in for many years, it may make sense to replace both.  Best Regards.

If you are otherwise happy with the implants and size it is fine to replace just the implant for the breast with capsular contracture. Patients often will take the opportunity to make changes to their implants if they are wanting something different if they have to address capsular contracture anyway.

If one breast is doing well, then leave it alone. Every surgery has risks. I would just replace the encapsulated side unless your doctor is choosing a different shaped implant.

Yes, it is certainly just fine to work on the breast that is encapsulated; this is  especially true if your breast augmentation was done recently?  In my practice, I would recommend that you leave well enough alone and work on the encapsulated side only. Best wishes for an outcome that you will be very pleased with.

It is ok to replace one as long as it is the same as before surgery. it would not use different textures or pocket positions without doing the same or similar on the opposite side.

It is possible to operate on only one side. In my patients I usually consent them to open the opposite side of necessary, but most of the time if it is a grade one capsule it doesn't need to be addressed. And I have numerous times over the years exchanged just one side for a textured implant while leaving a smooth on the opposite side. The first time I did it I worried that the patient would feel or see a difference, however, it turns out that with a silicone implant even I cannot feel or see a difference between textured and smooth in the same patient. It was at that point I started to use More textured implants because of capsular contracture. The other argument to not bothering the other side is that every time you open that pocket you risk contamination. Talk with your doctor about doing the affected side, but give her or him the leeway to address the "unaffected" if they don't match on the table. I hope this helps 

*Contracture is predominantly one sided. It is very rare to have it occur on both sides simultaneously. In the majority of cases working on the affected side is all that is needed. There is an old adage that says if it ain't broke don't fix it. This applies to breast augmentation especially.  The issue in your particular case is that the doctor wants to put in a different shaped implant which will look different than the original. You can put it in the same size and shape im plant after a capsular contracture has occurred. You should consult with a board-certified plastic surgeon who is experienced in breast surgery if you need a second  opinion 

In general, it is fine to address only one implant, particularly if the other one is completely fine.  There are risks to doing even a "minor" procedure to an implant, and I would not necessarily recommend that lightly.  If both implants have been in for a longer time (10+ years) then it may make sense to replace both.  I would normally try to use the same implants on both sides, even with the understanding that breasts are different and that they will not be exactly the same no matter what you do.  You should of course discuss this with your own plastic surgeon, and consider a second opinion from another board-certified plastic surgeons who can examine you in person.  I hope that this helps and good luck.  Dr. Alan Engler, Member of #RealSelf500